MIH exam 3 Flashcards
(50 cards)
How long does the postpartum phase last?
6 weeks
What is involution?
Shrinking of the uterus
What is pitocin?
Synthetic form of oxytocin, will cause the uterus to contract
What happens if a client has a negative titer for rubella?
They should receive the vaccine subut postpartum because it’s a live vaccine and a teratogen (can cross the placenta), counseled to use birth control and avoid pregnancy 1-4 months after immunization. Not transferred through breast milk. Inquire about sensitivity to eggs
What vaccines can be given during pregnancy?
Hep B, Tdap
What is the average expected weight gain during pregnancy?
25 to 35 lbs (11 to 16 kg) for women with a normal prepregnancy weight
How many calories should intake increase by?
300 calories/day
When are caloric needs greater?
Last 2 trimesters
Why is folic acid important for pregnant women/all women of childbearing age?
Prevents neural tube defects and orofacial clefts in fetus
How many glasses a day should a pregnant woman drink?
8 to 10 8oz glasses per day
What is eating ice an indicator of?
Anemia
What is an episiotomy?
an incision made into the perineum to enlarge the vaginal outlet and facilitate birth
- Check the episiotomy/laceration site
- Institute measures to relieve pain
- Educate on the use of an ice pack for the first 24 hours, then sitz bath thereafter
- Analgesic spray or ointment as prescribed (dermoplast, benzocaine)
- clean technique peri care
- Wipe perineal area front to back, blot don’t wipe (warm water bottle to cleanse the area)
- witch hazel pads (tucks pads) placed on peri pads
- stool softener
- monitor for s/sx of infection
- report any bleeding or discharge from the site to PHCP
What are nursing interventions for an episiotomy/perineal laceration?
- Labor is not progressing
- Fetal wellbeing
- Breach baby (footling breach, breach babies have a higher risk for complications during delivery)
- History of spinal cord injury
- Certain STDs
- If mother has a history of c section
- If the baby is big
What are reasons someone might get a C section?
How much does fundal height decrease?
1 to 2 centimeters below the umbilicus per day
When can the uterus not be palpated abdominally?
By week 2
Discharge from the uterus that consists of blood from the vessels of the placental site and debris from the decidua, result of involution and the regeneration of the endometrium
lochia rubra: red, present for first 3 to 4 days
lochia serosa: pinkish brown, can last up to 4 weeks postpartum
lochia alba: whitish color, noted up to 6 weeks postpartum
should smell like normal menstrual flow, may increase with ambulation, decreases daily in amount
during fundal rub nurses should assess lochia (huge part of postpartum assessment): check the peri pad prior to rubbing, what is coming out? what color is it? how much? what does it smell like?
What is lochia?
What does a boggy fundus indicate?
Uterine atony - inability of uterus to stay contracted. leads to postpartum hemorrhage
Interventions: massage fundus until firm
inability of uterus to return to non pregnant state.
Contributing factors: full bladder, mother should void before fundal rub. Tender fundus indicates infection, may be a sign of sub involution.
Long labor (18+ hours), anesthesia (epidural), multiparity (previous labors can slow involution, with each labor the chances of sub involution will be increased)
What is sub involution?
as early as 27 days
1 to 2 months in non breastfeeding mothers
3 to 6 months in breastfeeding mothers
Breast-feeding mothers may experience amenorrhea during the entire period of lactation so long as they are exclusively breastfeeding
first 3 to 4 menstrual cycles will be heavier
When does menstrual flow resume postpartum?
- A decrease in estrogen and progesterone levels after birth from pregnant to nonpregnant state stimulates increased prolactin levels, which promote breast milk production
- Breasts continue to secrete colostrum for the first 48 to 72 hours after birth (colostrum is rich in antibodies, high in protein, low in fat)
- milk will be readily available to nurse the newborn within 72 to 96 hours
- Immunoglobulins are passed through breastmilk
- The more the nipples are stimulated the more milk production occurs
What happens to the breasts postpartum?
What do breastfed babies need?
Supplemental vitamin D, given in the form of oral drops
- Nipple stimulation will release oxytocin which is responsible for the milk ejection reflex (oxytocin aids in uterine contraction)
- Decreases risk of SIDS, respiratory infections, GI infections/complications, in mother breast or ovarian cancer
What are the benefits of breastfeeding?
- HIV is passed through breastmilk
- Active TB is passed
- Galactosemia: baby is unable to metabolize milk protein and cannot have milk protein at all
What are the contraindications for breastfeeding?
